Angiographic Diagnosis of Hepatic Rupture

Advance in the surgical ability to treat hepatic rupture has surpassed the diagnostic effectiveness of exploratory laparotomy. This frustrating situation has been aptly expressed by Solheim: “The damage to the liver parenchyma may be diffuse and vary widely in extent. A superficial defect in closed liver injuries may be merely an outward sign of general intrahepatic damage of unknown and varying extent, and it is this which threatens the patient's life. Consequently laparotomy affords little prospect of assessing the prognosis, however well the visible liver damage seems to have been sutured” (11). Hepatic trauma is attended by high morbidity and mortality rates, despite the fact that its incidence is highest in the vigorous young male. One-third of those incurring hepatic injuries do not survive long enough to receive treatment. The immediately fatal injuries are characteristically multiple and are commonly accompanied by laceration of the heart and aorta (75 per cent). Another third succumb from the inj...